Comparing the Effect of Bobath Therapy and Motor Relearning Programme on Upper Limb Function in Patients with Cerebrovascular Accident: A Randomized Controlled Trial
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Abstract
Background: Upper limb dysfunction after cerebrovascular accident (CVA) restricts reaching, grasping, manipulation and independence in activities of daily living. Bobath Therapy emphasizes postural alignment, selective movement and sensory-motor facilitation, whereas the Motor Relearning Programme (MRP) emphasizes task analysis, repeated practice and transfer of learning. Methods: A prospective randomized controlled trial included 40 medically stable patients aged 50-75 years with first-ever unilateral CVA and upper limb motor deficit. Participants were allocated to Bobath Therapy (n=20) or MRP (n=20). Both groups received 12 supervised sessions over four weeks, approximately 60 minutes per session. Outcomes were Fugl-Meyer Assessment for Upper Limb (FMA-UL), Wolf Motor Function Test (WMFT), Modified Ashworth Scale (MAS) and Barthel Index. Paired t-tests assessed within-group change; independent t-tests, chi-square tests and one-way ANOVA were used as appropriate. Results: Both groups improved significantly after intervention. FMA-UL improvement was 16.96 ± 3.99 in the Bobath group and 14.22 ± 3.91 in the MRP group (p=0.035). WMFT improvement was 1.88 ± 0.32 versus 1.53 ± 0.43 (p=0.006), MAS reduction was 1.00 ± 0.33 versus 0.73 ± 0.37 (p=0.020), and Barthel Index improvement was 26.71 ± 5.54 versus 19.74 ± 5.79 (p<0.001). Conclusion: Both Bobath Therapy and MRP were effective for short-term upper limb rehabilitation after CVA, but Bobath Therapy produced greater improvement in motor control, functional performance, spasticity reduction and functional independence in this sample.
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